Allergic rhinitis is an inflammation in the nose which takes place when the body’s immune system overreacts to allergens in the air. These allergic symptoms are triggered easily by everyday things like house dust/ They can be very uncomfortable and disruptive to daily life — some patients even report negative effects on their quality of sleep.
Allergic rhinitis affects almost 10-30% people worldwide annually, and it is is the most common type of rhinitis. It is also colloquially known as “hay fever”. This came about due to an early misconception during the 1800s that the onset of allergic rhinitis symptoms was brought about “by the smell of hay in the morning”, hence the term, “hay fever”.
Due to Singapore’s tropical climate and high humidity, allergic rhinitis is very common here. It is believed that 20% of the population may have this condition. Further, having symptoms of allergic rhinitis is higher in the paediatric group.
Patients of allergic rhinitis are extra sensitive to airborne allergens, which include things like house dust mites, molds, cat’s or dog’s dander or grass. Exposure to these allergens will trigger an allergic reaction which can offset a reaction within the nose resulting in blocked nose, runny nose and sneezing. One way to identify allergic rhinitis is the colour of the fluid from the nose — the fluid is often clear, unlike bacterial infections where the phlegm and nasal fluid is often coloured.
Allergic rhinitis has also been said to occur seasonally, mostly triggered when the pollen season commences. This is known as seasonal allergic rhinitis. Symptoms are the same as seasonal rhinitis. Treatment includes nasal sprays and antihistamine tablets. For severe allergic rhinitis, an allergy test which involves the prick of the skin can be performed to see what the potential triggers are. However, key treatment for allergic rhinitis is to avoid allergens that trigger symptoms. For recalcitrant problematic cases of allergic rhinitis, nasal surgeries can be performed to improve nasal airflow.
- dog dander
- cat dander
- grass bollen
- birch pollen
- daisy pollen
- dust mites
While it can be difficult to completely avoid the allergen, there are several ways to reduce exposure from it. A good start is to vacuum your room every time you have allergic symptoms. The less you are exposed to common allergic triggers like dust mites, pollen, or animal dander, it is likely that symptoms that were once severe will become milder or disappear completely.
Immunotherapy, otherwise known as allergy shots, are also a long term treatment for allergic rhinitis. Allergy shots containing allergens are injected into the body over 3-5 years to develop resistance.
For ease of administration, immunotherapy is available in the form of sublingual tables too. As immunotherapy is a 3-year course, of long term commitment is required for a good outcome.
For patients who are still troubled by nasal congestion and other symptoms despite treatment, a simple procedure to reduce the size of the inferior turbinates (radiofrequency) can be performed. The inferior turbinate is a structure that is commonly enlarged during allergic rhinitis. This can be performed under local anaesthesia in the clinic. The downtime is not severe and patients can usually return straight to work after.
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